氟-18-氟代脱氧葡萄糖正电子发射断层扫描（Fluorine-18-FDG PET）和碘-123-间碘苄胍单光子发射计算机断层扫描（iodine-123-IMT SPECT）在脑肿瘤评估中的应用

Fluorine-18-FDG PET and iodine-123-IMT SPECT in the evaluation of brain tumors.

作者信息

Weber W, Bartenstein P, Gross M W, Kinzel D, Daschner H, Feldmann H J, Reidel G, Ziegler S I, Lumenta C, Molls M, Schwaiger M

机构信息

Department of Nuclear Medicine, Klinikum Rechts der Isar, Germany.

出版信息

J Nucl Med. 1997 May;38(5):802-8.

PMID:9170450

Abstract

UNLABELLED

The high glucose utilization of normal gray matter limits the detection of brain tumor tissue by PET using 18F-fluorodeoxyglucose (FDG). The aim of this study was to evaluate whether the examination of amino acid transport with the SPECT tracer 123l-alpha-methyl-L-tyrosine (IMT) allows better identification of tumor tissue than FDG-PET.

METHODS

Nineteen patients (16 with gliomas, 3 with nontumorous lesions) were included in the study. Two independent observers classified PET and SPECT images as positive or negative for tumor tissue and defined the extent of tumor with regions of interest. Tracer uptake of FDG and IMT was quantified by calculating the tumor uptake relative to contralateral gray and white matter.

RESULTS

SPECT studies were interpreted concordantly in 18 patients (kappa = 0.77) and all tumors were identified by both observers. PET studies were interpreted discordantly in 4 patients (kappa = 0.52) and only 10 tumors were identified by both observers, interobserver variability in definition of tumor extent was significantly lower in the IMT-SPECT than in the FDG-PET studies (p = 0.03). Mean tumor uptake relative to gray and white matter was 1.93 +/- 0.42 and 2.25 +/- 0.46 for IMT and 0.93 +/- 0.32 and 1.61 +/- 0.52 for FDG. All tumor uptake ratios were significantly (p < 0.01) higher for IMT than FDG, even when only glioblastomas were analyzed. No significant correlation was observed between the various uptake ratios of FDG and IMT.

CONCLUSION

Despite the lower resolution and lower sensitivity of SPECT compared with PET, IMT-SPECT was clearly superior to FDG-PET in the detection and delineation of tumor tissue.

摘要

未标注

正常灰质对葡萄糖的高利用率限制了使用18F-氟脱氧葡萄糖（FDG）的PET对脑肿瘤组织的检测。本研究的目的是评估用SPECT示踪剂123I-α-甲基-L-酪氨酸（IMT）检测氨基酸转运是否比FDG-PET能更好地识别肿瘤组织。

方法

19例患者（16例患有胶质瘤，3例患有非肿瘤性病变）纳入本研究。两名独立观察者将PET和SPECT图像分类为肿瘤组织阳性或阴性，并用感兴趣区域确定肿瘤范围。通过计算相对于对侧灰质和白质的肿瘤摄取量来量化FDG和IMT的示踪剂摄取。

结果

18例患者的SPECT研究结果一致（kappa = 0.77），两名观察者均识别出所有肿瘤。4例患者的PET研究结果不一致（kappa = 0.52），两名观察者仅识别出10个肿瘤，IMT-SPECT研究中肿瘤范围定义的观察者间变异性明显低于FDG-PET研究（p = 0.03）。IMT相对于灰质和白质的平均肿瘤摄取量分别为1.93±0.42和2.25±0.46，FDG分别为0.93±0.32和1.61±0.52。即使仅分析胶质母细胞瘤，IMT的所有肿瘤摄取率也显著高于FDG（p < 0.01）。FDG和IMT的各种摄取率之间未观察到显著相关性。